| NPI | 1063614543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361005154) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MI 6301009105) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2023-09-11 |